Evaluation of force applied during deliveries complicated by shoulder dystocia using simulation.

Abstract

We sought to objectively evaluate the amount of force applied during deliveries complicated by shoulder dystocia among different providers. Providers who do deliveries at our institution were approached for participation. The simulation exercise used a childbirth mannequin that measures the amount of force the provider applies to the fetal head during delivery. The amount of force applied and information regarding the provider's level of experience, height, weight, and gender was recorded. This study was approved by the hospital institutional review board. A total of 47 providers participated. The mean force applied during each situation was not associated with the provider's experience, height, weight, or gender. Provider experience, gender, and body habitus were not associated with the amount of force applied during delivery. We found differences between family medicine and obstetrics/gynecology providers. In addition, a significant number of all providers (19/47, 40%) pulled >100 N.